Braid’s Final Thoughts on Hypnotism

James Braid, the Scottish surgeon who discovered hypnotism, wrote many small books and articles on the subject, most of which were never republished after his death.  Our understanding of the origin of hypnotism has often depended upon comparisons with its forerunner and opponent, Mesmerism or “animal magnetism”, and a republished edition of Braid’s first book Neurypnology (1843).  However, Braid revised and developed his views for another seventeen years until his death in 1860.  Just before he died, Braid had composed a manuscript summarising his life’s work and his mature view of hypnotism and hypnotherapy.  This manuscript was apparently lost, although 19th century French and German translations of it remain. 

As part of the research for my recent publication The Discovery of Hypnosis: The Complete Writings of James Braid, the Father of Hypnotherapy, which contains most of Braid’s collected works, I undertook a backward translation of the French and German copies of this “lost manuscript” into Victorian English.  Some of the views expressed by Braid shed considerable light on the origin of hypnotherapy, its relation to modern psychotherapy approaches such as CBT, and illustrate certain concepts and techniques which were forgotten by later hypnotists, but may still be of practical value today, such as Braid’s fundamental concept of “muscular suggestion.”  Perhaps most importantly, Braid’s writings help to correct a number of common misconceptions that have arisen regarding hypnotism, largely as a result of it being confused in the minds of the public with the contrary views of Franz Anton Mesmer and the “animal magnetists” who preceded Braid and opposed him throughout his career.  The Mesmerists believed that they influenced people by means of an invisible magnetic fluid, whereas Braid, a sceptic, repeatedly carried out experiments to debunk their claims and demonstrate instead that similar psychological, behavioural and physiological effects could be induced through hypnotism, using only suggestion, focused attention, and physical manipulation, etc.

The Nature of Hypnotism

Braid re-iterates the view found in his other mature writings, that some subjects will respond to suggestion very powerfully without the use of hypnotic induction or with their eyes open, although the “hypnotic process” of eye-fixation and mental concentration tends to enhance suggestibility.  Braid was also very aware of the power of observational learning in social role-modelling, and made extensive use of it in his work by hypnotising subjects in group settings where they could learn to imitate the responses of other highly hypnotisable subjects.

Some individuals may themselves be deceived by the compelling words of other individuals, but a much more significant number fall into the same state after being hypnotised by continuous eye-fixation upon an object and concentration of mind.  This state can even be established before the eyelids are closed or a pronounced tendency to sleep has been felt.  Suggestibility can also be increased by the sight of other patients in the experiment, and that by virtue of the laws of sympathy and imitation.  (Braid, 1860)

Although he retained the term “hypnotic” to describe the whole process, Braid distinguished between full hypnotism and partial or sub-hypnotic states which he subsequently came to feel it was misleading and counter-productive to describe as “sleep” or hypnotism rather than as a kind of daydreaming or reverie.

Strictly speaking, the word hypnotism should be reserved only for those patients who actually fall into a state of sleep, and who forget upon awakening all that occurred during this state.  When this is lacking, it is a question merely of reverie or dreaming.  It would therefore be apposite to establish a terminology, characterising these modifications which result from the hypnotic process; indeed, with regard to those conditions resistant to ordinary medication and suitable for cure by hypnotism, hardly one patient in ten arrives at the unconscious stage of sleep (at least for the whole duration of the process).  The word “hypnotism” can then lead them into error and make them believe that they do not benefit in any way from a process of which the characteristic and obvious effects do not appear to be those that the name [i.e., "hypnotic sleep"] indicates. (Braid, 1860)

In other words, only 10% of Braid’s subjects entered into a sleep-like state characterised by spontaneous blanket amnesia.  The other 90% were conscious and experienced a wide variety of different states of mind, mainly states of relaxation, abstraction, reverie and daydreaming, usually with slight amnesia or none at all.  He bemoans, as most modern hypnotherapists, the fact that his subjects tend to doubt whether they have genuinely been hypnotised if they have not experienced total amnesia, and Braid blames this troublesome misconception on his own use of the word “hypnotism” with its connotation of unconscious sleep.  Braid therefore suggested reserving the expression “hypnotism” for the state, occuring about 10% of the time, in which subjects experience a sleep-like state of total amnesia.  He also referred to this as “double consciousness” because subjects seemed to be actually conscious and responsive during hypnosis, but to lack any recollection of it upon awakening.  He also recognised a more profound, and presumably exceptionally rare, state of hypnotism which he termed “hypnotic coma”, “trance” or “human hibernation”, which was accompanied by very profound amnesia, total unconsciousness, and spontaneous anaesthesia to pain.

The Interaction of Mind & Body (Psychophysiology)

Braid coined the term “mono-ideo-dynamic” to refer to the power of focused attention upon a dominant idea (or image) to dynamically influence muscular movement and the physiology of the body by means of a reflex-like response, which he elsewhere terms “the power of the mind over the body”.  He also coined the term “psychophysiology” to refer to the more general inter-action between mind and body.  These terms parallel the modern expression “cognitive-behavioural” in some respects.  They are all attempts to designate the parallel and interacting processes of the mind (psyche, cognition, idea) and body (behaviour, physiology).

Braid therefore distinguished between the power of mental images (ideas) to influence the body and the reverse, the power of the body to evoke ideas and emotions.  He describes in detail a method he terms “muscular suggestion” whereby manipulation of the bodily posture, gestures, and facial expression of certain subjects proved sufficient to evoke all manner of subjective experiences.  In particular, he refers to pinching the brow, to contract it into an expression of distress.  He provides the example of a kneeling subject who tilted his head toward the sky and expressed feelings of Heavenly rapture, but when he was made to frown and lower his head, perceived Hell, and reacted with alarm.

As we said, the position of the body significantly influences the emotions and sensations during the desired stage of hypnotism; also, whatever the passion which one wants to express by the attitude of the patient, when the muscles necessary to this expression are brought into play, the passion itself bursts forth suddenly and the whole organism responds accordingly.  The upright body, the expanded chest, the contracted extensors, all that suggests the feeling of self-esteem, self-determination, resolve and unconquerable pride.  As soon as one decreases the contraction of these muscles, that gives to the patient a depressed attitude, with a sunken chest, the expression of the features changes in a very manifest way, the voice and the whole manner of being of the individual now express humility, abasement and pity. (Braid, 1860)

He continues,

In this way, we influence the muscles of physiognomy [facial expression] and it is possible for us to arouse any passion or sentiment whatsoever; the contraction of the interconnected muscles, constituting “the anatomy of expression”, evokes in the brain of the hypnotised person certain impressions just as these, in the waking state, determine the whole facial expression.  It is thus merely a reversal of the usual order [of causation] between the emotions and their physical expressions. (Braid, 1860)

Braid explained the effect of the famous “Mesmeric passes” in a similar way.  The Mesmeristsbelieved that they influenced the flow of a magnetic fluid or energy through the body of their patients by various gestures in which, e.g., they made long strokes called “passes”, lightly across the surface of the subject’s body, in one direction or another.  Subjects would respond by relaxing or tensing their muscles accordingly.  For example, if a subject raised their arm in the air, the Mesmerist might stroke his fingertips along the length of the arm to induce a feeling of heaviness so that the subject would feel like lowering it.  On the other hand, if the hand was resting on their lap, the passes might induce a feeling of lightness, and a gradual contraction of the muscles, raising the arm progressively.  Rather than being the result of some invisible magnetic force, Braid argued that different passes across the skin induced the subject to tense or relax the underlying muscles in different ways, causing associated feelings such as lightness or heaviness.

The Role of Expectation & Suggestion

A century later, behaviour therapists concluded that the effects of relaxation and other physical or behavioural strategies were “mediated” or determined by cognitions, the clients attitudes and expectations.  Braid likewise recognised that physical manipulations appeared to have some degree of inherent effect, but that this could be powerfully shaped by verbal suggestions and the client’s expectations.

It is however possible, by education, to entirely invert the order of these natural phenomena: suppose that the operator [hypnotist] speaks, with each pass or with each movement that he executes, and that he says in advance what will happen, then what he said in advance can take place instead of what would have occurred naturally. (Braid, 1860)

As Braid notes, subjects will also tend to respond in the way they have come to expect by observing the behaviour of other subjects undergoing the same process as themselves, through the “law of sympathy and imitation.”  Hence, there tends to arise a reciprocal inter-action between the mind and body which Braid termed “psycho-physiology”, ideas and suggestions evoking bodily responses, including muscular movement and changes in facial expression, which in turn evoke subjective feelings and spontaneous ideas, and vice versa.

One draws several important conclusions from the consideration of the phenomena which take place in consequence of the power of primary impressions, lively faith, and attention concentrated on dominant ideas, causes which contribute to modifying physical action, so that the new physical state reacts on the mental activity.  It is possible for us today not only to understand the [psychological and physiological] cause and treatment of many diseases on which no specific external influence, nor internal drugs had any effect, but also to explain a great number of phenomena which were attributed to demonology and magic, ghosts and enchantments, to the power of witches who abused and killed their gullible victims by means of hexes and their harmful influence, so readily accepted. (Braid, 1860)

Hence, Braid dismisses many supernatural phenomena and the like as the result of psychological and physiological factors inter-acting, as in hypnotic suggestion,

All that produces a strong excitation, all that modifies the preliminary state of the thoughts and the feelings, surely also modifies the mental and physical state of the individual, especially if it occurs with confidence, expectation, and concentration of mind. (Braid, 1860)

However, Braid repeatedly emphasised, in opposition to the Mesmerists, that hypnotism could create no new powers or abilities, but merely enhance normal psychological functioning,

All these phenomena, however extraordinary they are, are only the result of a heightening of the intellectual functions or power, which we all have to an average degree in the ordinary or waking state.  (Braid, 1860)

In this, and other regards, Braid comes surprisingly close to the modern nonstate or cognitive-behavioural theory of hypnosis, propounded by Sarbin, Barber, and others.  Both Braid and the cognitive-behavioural hypnotists emphasise the continuity between normal psychological and physiological functions and hypnotic responses.  They eschew the word “trance” as misleading, except perhaps for the more abnormal responses found in a minority of highly responsive subjects.  Instead, both Braid and the cognitive-behavioural theorists explain hypnosis in terms of a variable combination of ordinary psychological factors such as focused attention, imagination, expectation, social imitation, suggestion and autosuggestion, spontaneous or deliberate mental imagery, etc.  In the same way that they use the term “cognitive-behavioural” to emphasise the role of ordinary mental and physical factors, Braid termed his theory of hypnotism “psycho-physiological” and repeatedly emphasised that it employed well-established laws of psychology and physiology consistent with what we now call a “sceptical” and Braid would have termed a “rational” and “common sense” orientation.  For these, reasons, I think it is time for something of a “return to Braid”, a return to the origin of hypnotism, or at least a greater appreciation of the extent to which the arguments in this field are cyclical in nature and have tended to replicate the arguments played out in his lifetime by Braid in vigorous opposition to the pseudoscientific and occult views of Mesmer and famous British magnetists like John Elliotson and James Esdaile.